September 2023 ASPHP Newsletter

Lift Up Rehab – SPHM Improves Quality and Safety

Nancy McGann PT, CSPHP, CPPS, Leader of Safe Patient Handling,
Mobility and Fall Prevention Intermountain Health

As a physical therapist, when I first heard about Safe Patient Handling in the early 2000’s my initial instinct was concern that this may stop patients from moving. Therefore, it could make therapy less successful and worsen patient outcomes. I also thought it may take away the touch and human interaction that can be so healing. However, my background in ergonomics led me to consider an alternative possibility. When great ergonomic interventions were implemented in industry, quality also improved.

My first experience with the effect of ergonomic interventions on quality and safety was in the 1990’s when redesigning an area of an assembly line that made circuits. I was hired by an employee health department because there were several neck injuries where circuits were manually wired. We improved the height and angle of the line in this area as well as the lighting. We also added sit-stand stools. Three months later the same company contacted me to look at their entire line. I asked if there were injuries in other areas and the response amazed and pleased me. The quality control leader noted a 40% reduction in waste because errors in wiring declined. When he looked at what changed, the only thing was the ergonomic modification in that one area. What prevented neck pain, also improved quality because they could better visualize the wires. They wanted to look at more design changes to further drive down error rates. For the first time, I was asked to consult with the primary goal of improving quality and not preventing injury. More changes were made, and their error rates diminished by another 10%. Line productivity also increased with the added changes. It was a win-win!

After 17 years of leading Safe Patient Handling & Mobility programs, I have seen the exact same thing occur; quality of care improves! The same intervention that protects our caregivers from harm, also protects our patients and allows us to provide higher quality care. An easy example is the friction that harms our shoulders and backs, also harms our patient’s skin when we manually boost. We see both Patient Handling Injuries and HAPIs go down when boosting with SPHM Technology. Please review a great example of this related to proning: https://www.psqh.com/news/psqh-innovation-awards-winner-scl-health-improves-process-for-prone-positioning-of-covid-19-patients/

It was recently mentioned in our ASPHP Discussion Group that there is still a strong belief by many physical and occupational therapists that this technology will hinder their ability to rehabilitate their patients. Perhaps the link to quality in therapy is not as obvious or perhaps the engrained education in body mechanics is the reason for this belief.

Below are some key points to remember that support the use of SPHM technology to improve the quality of care we can deliver with a focus on rehabilitation.

• Technology allows us to start our patient in the most therapeutic position. Is it always best to start therapy supine and in bed? Would a chair allow more therapeutic benefit? We can conserve their energy for the most therapeutic task using lift technology.
• Technology allows us to reduce or eliminate fear as a limitation in rehab. Walking slings and stand aids can be used so patients are comfortable to push their limits without a fear of falling.
• What is limiting therapy sessions? Is it the patient’s true limitations or the therapist’s fatigue or fear that their patient may fall?
• Can we accomplish a therapy session without an assistant if we have technology? Do we need someone following with a wheelchair if we have a walking sling?
• Is it more therapeutic for me to be tapping my patient’s quads and guiding their heels to strike when ambulating or to be holding them up with a gait belt?
• Is physically lifting and transferring someone therapeutic touch? Can we better view our patient’s facial expressions if we are next to them using a lift or hugging and lifting them?

Factors that limit rehab such as fear, fatigue, weakness, and poor balance can be minimized with the active-assistive use of lift technology.  I urge everyone to share how they use SPHM technology in an active-assistive way to promote mobility safely. Passive lift use has a place in patient care, but lifts are also a critical tool in the rehab process!

Let’s commit to sharing more ideas in the discussion group to support our members and create environments where lifts are fully utilized by our rehab professionals!